Goiter history and symptoms: Difference between revisions

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{{Goiter}}
{{Goiter}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{ARK}}
==Overview==
==Overview==
A history of low iodine intake, history of use of therapeutic drugs that hinder normal thyroid hormonal activity, [[radiation exposure]] and positive family history of thyroid diseases. Symptoms of goiter include, swelling at the base of the neck, [[difficulty swallowing]], [[hoarseness of voice]] and [[difficulty in breathing]].
Obtaining history may provide important information in the diagnosis of goiter. It provides insight into cause, precipitating factors and associated comorbid conditions. Patients of goiter usually have a history of low [[iodine]] intake, history of use of [[therapeutic]] [[drugs]] that hinder normal [[Thyroid hormones|thyroid hormonal]] activity, [[radiation exposure]] and positive [[family history]] of [[thyroid diseases]]. Common symptoms of goiter include, [[swelling]] at the base of the neck, [[difficulty swallowing]], [[hoarseness]] of voice and [[difficulty in breathing]].


==History and Symptoms==
==History and Symptoms==
===History===
===History===
Patients with goiter may have a history of:
Obtaining history may provide important information in the diagnosis of goiter. It provides insight into cause, precipitating factors and associated comorbid conditions. Patients with goiter may have a history of:
*Low iodine intake (geographical/regional factors and food habits)
*Low [[iodine]] intake (geographical/regional factors and food habits),
*History of the use of therapeutic drugs that hinder normal thyroid hormonal activity
*History of the use of [[therapeutic]] [[drugs]] that hinder normal [[Thyroid hormones|thyroid hormonal]] activity,
*[[Radiation exposure]] (therapeutic or accidental exposure)
*[[Radiation exposure]] (therapeutic or accidental exposure),
*Positive family history of thyroid diseases (benign or malignant variants)
*Positive [[family history]] of [[thyroid]] [[diseases]] ([[benign]] or [[malignant]] variants).


===Symptoms===
===Symptoms===
Symptoms of of a patient suspected of goiter are evaluated based on:<ref name="pmid15632316">{{cite journal| author=Kahaly GJ, Dillmann WH| title=Thyroid hormone action in the heart. | journal=Endocr Rev | year= 2005 | volume= 26 | issue= 5 | pages= 704-28 | pmid=15632316 | doi=10.1210/er.2003-0033 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15632316  }} </ref><ref name="pmid24823702">{{cite journal| author=Refetoff S, Bassett JH, Beck-Peccoz P, Bernal J, Brent G, Chatterjee K et al.| title=Classification and proposed nomenclature for inherited defects of thyroid hormone action, cell transport, and metabolism. | journal=J Clin Endocrinol Metab | year= 2014 | volume= 99 | issue= 3 | pages= 768-70 | pmid=24823702 | doi=10.1210/jc.2013-3393 | pmc=3942236 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24823702  }} </ref><ref name="pmid17209221">{{cite journal| author=Cooper DS| title=Approach to the patient with subclinical hyperthyroidism. | journal=J Clin Endocrinol Metab | year= 2007 | volume= 92 | issue= 1 | pages= 3-9 | pmid=17209221 | doi=10.1210/jc.2006-2472 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17209221  }} </ref>
[[Symptoms]] of of a patient suspected of goiter are evaluated based on:<ref name="pmid15632316">{{cite journal| author=Kahaly GJ, Dillmann WH| title=Thyroid hormone action in the heart. | journal=Endocr Rev | year= 2005 | volume= 26 | issue= 5 | pages= 704-28 | pmid=15632316 | doi=10.1210/er.2003-0033 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15632316  }} </ref><ref name="pmid24823702">{{cite journal| author=Refetoff S, Bassett JH, Beck-Peccoz P, Bernal J, Brent G, Chatterjee K et al.| title=Classification and proposed nomenclature for inherited defects of thyroid hormone action, cell transport, and metabolism. | journal=J Clin Endocrinol Metab | year= 2014 | volume= 99 | issue= 3 | pages= 768-70 | pmid=24823702 | doi=10.1210/jc.2013-3393 | pmc=3942236 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24823702  }} </ref><ref name="pmid17209221">{{cite journal| author=Cooper DS| title=Approach to the patient with subclinical hyperthyroidism. | journal=J Clin Endocrinol Metab | year= 2007 | volume= 92 | issue= 1 | pages= 3-9 | pmid=17209221 | doi=10.1210/jc.2006-2472 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17209221  }} </ref>
*Patient's age
*[[Age]] of the patient
*Patient's sex
*Gender of the patient
*'''''Major presenting complaints:'''''
*'''Major presenting complaints:'''
**Anterior neck swelling:
**[[Anterior]] [[neck]] swelling:
***Duration
***Duration
***Mode of onset
***Mode of onset
***Rate of growth
***Rate of [[growth]]
***Associated pain
***Associated pain
*'''''Pressure-related symptoms:'''''
*'''Pressure-related symptoms:'''
**[[Dysphagia]]
**[[Dysphagia]]
**[[dyspnea]]
**[[Dyspnea]]
**[[Hoarseness|Hoarseness of voice]]
**[[Hoarseness|Hoarseness of voice]]
**Venous engorgement of the neck
**[[Venous]] engorgement of the [[neck]] (especially on raising [[hands]] above [[head]]- [[Pemberton's sign]])
*'''''Review of systems to assess toxicity:'''''
*'''Review of systems to assess toxicity:'''
**'''CNS:''' [[tremors]], irritability, mental disturbance
**'''CNS:''' [[tremors]], [[irritability]], mental instability
**'''CVS:''' [[palpitation]], [[dyspnea]], [[orthopnoea]]
**'''CVS:''' [[palpitation]], [[dyspnea]], [[orthopnoea]]
**'''GI:''' change of appetite, [[constipation]], [[diarrhoea]]
**'''GI:''' Change of [[appetite]], [[constipation]], [[diarrhea]]
**'''Musculo skeletal system:''' bone pain, weight change, heat or cold preference, excessive sweating
**'''Musculoskeletal system:''' [[Bone pain]], [[weight change]], heat or cold preference, and [[excessive sweating]]
*'''''Past medical history:'''''
*'''Past medical history:'''
**Previous medication, previous history of radiation exposure
**Previous [[medication]], previous history of [[radiation exposure]]
*'''''Family and social history:'''''
*'''Family and social history:'''
**History of goitre in the family or in the community
**History of goiter in the [[family]] or in the community


===Common Symptoms===
===Common Symptoms===
Common symptoms of goiter include:<ref name="pmid21543434">{{cite journal| author=Bahn RS, Castro MR| title=Approach to the patient with nontoxic multinodular goiter. | journal=J Clin Endocrinol Metab | year= 2011 | volume= 96 | issue= 5 | pages= 1202-12 | pmid=21543434 | doi=10.1210/jc.2010-2583 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21543434  }} </ref><ref name="pmid12588812">{{cite journal| author=Hegedüs L, Bonnema SJ, Bennedbaek FN| title=Management of simple nodular goiter: current status and future perspectives. | journal=Endocr Rev | year= 2003 | volume= 24 | issue= 1 | pages= 102-32 | pmid=12588812 | doi=10.1210/er.2002-0016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12588812  }} </ref><ref name="pmid17670208">{{cite journal| author=Ket S, Ozbudak O, Ozdemir T, Dertsiz L| title=Acute respiratory failure and tracheal obstruction in patients with posterior giant mediastinal (intrathoracic) goiter. | journal=Interact Cardiovasc Thorac Surg | year= 2004 | volume= 3 | issue= 1 | pages= 174-5 | pmid=17670208 | doi=10.1016/S1569-9293(03)00270-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17670208  }} </ref><ref name="pmid15615818">{{cite journal| author=Krohn K, Führer D, Bayer Y, Eszlinger M, Brauer V, Neumann S et al.| title=Molecular pathogenesis of euthyroid and toxic multinodular goiter. | journal=Endocr Rev | year= 2005 | volume= 26 | issue= 4 | pages= 504-24 | pmid=15615818 | doi=10.1210/er.2004-0005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15615818  }} </ref><ref name="pmid11788631">{{cite journal| author=Thieblemont C, Mayer A, Dumontet C, Barbier Y, Callet-Bauchu E, Felman P et al.| title=Primary thyroid lymphoma is a heterogeneous disease. | journal=J Clin Endocrinol Metab | year= 2002 | volume= 87 | issue= 1 | pages= 105-11 | pmid=11788631 | doi=10.1210/jcem.87.1.8156 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11788631 }} </ref><ref name="pmid8398533">{{cite journal| author=Nielsen J, Pedersen FM, Knudsen F, Jensen MB, Ibsen M| title=Accuracy of 94 anaesthetic agent vaporizers in clinical use. | journal=Br J Anaesth | year= 1993 | volume= 71 | issue= 3 | pages= 453-7 | pmid=8398533 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8398533 }} </ref>
Common [[symptoms]] of goiter include:<ref name="pmid21543434">{{cite journal| author=Bahn RS, Castro MR| title=Approach to the patient with nontoxic multinodular goiter. | journal=J Clin Endocrinol Metab | year= 2011 | volume= 96 | issue= 5 | pages= 1202-12 | pmid=21543434 | doi=10.1210/jc.2010-2583 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21543434  }} </ref><ref name="pmid12588812">{{cite journal| author=Hegedüs L, Bonnema SJ, Bennedbaek FN| title=Management of simple nodular goiter: current status and future perspectives. | journal=Endocr Rev | year= 2003 | volume= 24 | issue= 1 | pages= 102-32 | pmid=12588812 | doi=10.1210/er.2002-0016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12588812  }} </ref><ref name="pmid17670208">{{cite journal| author=Ket S, Ozbudak O, Ozdemir T, Dertsiz L| title=Acute respiratory failure and tracheal obstruction in patients with posterior giant mediastinal (intrathoracic) goiter. | journal=Interact Cardiovasc Thorac Surg | year= 2004 | volume= 3 | issue= 1 | pages= 174-5 | pmid=17670208 | doi=10.1016/S1569-9293(03)00270-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17670208  }} </ref><ref name="pmid15615818">{{cite journal| author=Krohn K, Führer D, Bayer Y, Eszlinger M, Brauer V, Neumann S et al.| title=Molecular pathogenesis of euthyroid and toxic multinodular goiter. | journal=Endocr Rev | year= 2005 | volume= 26 | issue= 4 | pages= 504-24 | pmid=15615818 | doi=10.1210/er.2004-0005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15615818  }} </ref><ref name="pmid11788631">{{cite journal| author=Thieblemont C, Mayer A, Dumontet C, Barbier Y, Callet-Bauchu E, Felman P et al.| title=Primary thyroid lymphoma is a heterogeneous disease. | journal=J Clin Endocrinol Metab | year= 2002 | volume= 87 | issue= 1 | pages= 105-11 | pmid=11788631 | doi=10.1210/jcem.87.1.8156 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11788631  }} </ref>
*Swelling at the base of the neck
*Swelling at the base of the [[neck]]
*[[Dysphagia]] (difficulty swallowing)
*[[Dysphagia]] (difficulty swallowing)
*[[Hoarseness]] (hoarse voice)
*[[Hoarseness]] (hoarse voice)
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===Less Common Symptoms===
===Less Common Symptoms===
Less common symptoms of [disease name] include  
Less common [[symptoms]] of goiter include  
*Pain in the area of enlargement/swelling
*Pain in the area of enlargement/[[swelling]]
*[[Wheeze]]
*[[Wheeze]]
*Phrenic nerve paralysis<ref name="pmid8398533">{{cite journal| author=Nielsen J, Pedersen FM, Knudsen F, Jensen MB, Ibsen M| title=Accuracy of 94 anaesthetic agent vaporizers in clinical use. | journal=Br J Anaesth | year= 1993 | volume= 71 | issue= 3 | pages= 453-7 | pmid=8398533 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8398533  }} </ref>
*[[Phrenic nerve paralysis]]<ref name="pmid8398533">{{cite journal| author=Nielsen J, Pedersen FM, Knudsen F, Jensen MB, Ibsen M| title=Accuracy of 94 anaesthetic agent vaporizers in clinical use. | journal=Br J Anaesth | year= 1993 | volume= 71 | issue= 3 | pages= 453-7 | pmid=8398533 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8398533  }} </ref>
*Jugular vein compression or thrombosis (rare)<ref name="pmid4913941">{{cite journal |vauthors=Siderys H, Rowe GA |title=Superior vena caval syndrome caused by intrathoracic goiter |journal=Am Surg |volume=36 |issue=7 |pages=446–50 |year=1970 |pmid=4913941 |doi= |url=}}</ref>
*[[Jugular vein]] compression or thrombosis (rare)<ref name="pmid4913941">{{cite journal |vauthors=Siderys H, Rowe GA |title=Superior vena caval syndrome caused by intrathoracic goiter |journal=Am Surg |volume=36 |issue=7 |pages=446–50 |year=1970 |pmid=4913941 |doi= |url=}}</ref>
*Cerebrovascular steal syndromes (rare) <ref name="pmid4913941">{{cite journal |vauthors=Siderys H, Rowe GA |title=Superior vena caval syndrome caused by intrathoracic goiter |journal=Am Surg |volume=36 |issue=7 |pages=446–50 |year=1970 |pmid=4913941 |doi= |url=}}</ref>
*Cerebrovascular steal syndromes (rare) <ref name="pmid4913941">{{cite journal |vauthors=Siderys H, Rowe GA |title=Superior vena caval syndrome caused by intrathoracic goiter |journal=Am Surg |volume=36 |issue=7 |pages=446–50 |year=1970 |pmid=4913941 |doi= |url=}}</ref>
*[[Superior vena cava syndrome]] (rare) <ref name="pmid4913941">{{cite journal |vauthors=Siderys H, Rowe GA |title=Superior vena caval syndrome caused by intrathoracic goiter |journal=Am Surg |volume=36 |issue=7 |pages=446–50 |year=1970 |pmid=4913941 |doi= |url=}}</ref>
*[[Superior vena cava syndrome]] (rare) <ref name="pmid4913941">{{cite journal |vauthors=Siderys H, Rowe GA |title=Superior vena caval syndrome caused by intrathoracic goiter |journal=Am Surg |volume=36 |issue=7 |pages=446–50 |year=1970 |pmid=4913941 |doi= |url=}}</ref>

Latest revision as of 11:42, 20 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]

Overview

Obtaining history may provide important information in the diagnosis of goiter. It provides insight into cause, precipitating factors and associated comorbid conditions. Patients of goiter usually have a history of low iodine intake, history of use of therapeutic drugs that hinder normal thyroid hormonal activity, radiation exposure and positive family history of thyroid diseases. Common symptoms of goiter include, swelling at the base of the neck, difficulty swallowing, hoarseness of voice and difficulty in breathing.

History and Symptoms

History

Obtaining history may provide important information in the diagnosis of goiter. It provides insight into cause, precipitating factors and associated comorbid conditions. Patients with goiter may have a history of:

Symptoms

Symptoms of of a patient suspected of goiter are evaluated based on:[1][2][3]

Common Symptoms

Common symptoms of goiter include:[4][5][6][7][8]

Less Common Symptoms

Less common symptoms of goiter include

References

  1. ↑ Kahaly GJ, Dillmann WH (2005). "Thyroid hormone action in the heart". Endocr Rev. 26 (5): 704–28. doi:10.1210/er.2003-0033. PMID 15632316.
  2. ↑ Refetoff S, Bassett JH, Beck-Peccoz P, Bernal J, Brent G, Chatterjee K; et al. (2014). "Classification and proposed nomenclature for inherited defects of thyroid hormone action, cell transport, and metabolism". J Clin Endocrinol Metab. 99 (3): 768–70. doi:10.1210/jc.2013-3393. PMC 3942236. PMID 24823702.
  3. ↑ Cooper DS (2007). "Approach to the patient with subclinical hyperthyroidism". J Clin Endocrinol Metab. 92 (1): 3–9. doi:10.1210/jc.2006-2472. PMID 17209221.
  4. ↑ Bahn RS, Castro MR (2011). "Approach to the patient with nontoxic multinodular goiter". J Clin Endocrinol Metab. 96 (5): 1202–12. doi:10.1210/jc.2010-2583. PMID 21543434.
  5. ↑ Hegedüs L, Bonnema SJ, Bennedbaek FN (2003). "Management of simple nodular goiter: current status and future perspectives". Endocr Rev. 24 (1): 102–32. doi:10.1210/er.2002-0016. PMID 12588812.
  6. ↑ Ket S, Ozbudak O, Ozdemir T, Dertsiz L (2004). "Acute respiratory failure and tracheal obstruction in patients with posterior giant mediastinal (intrathoracic) goiter". Interact Cardiovasc Thorac Surg. 3 (1): 174–5. doi:10.1016/S1569-9293(03)00270-6. PMID 17670208.
  7. ↑ Krohn K, Führer D, Bayer Y, Eszlinger M, Brauer V, Neumann S; et al. (2005). "Molecular pathogenesis of euthyroid and toxic multinodular goiter". Endocr Rev. 26 (4): 504–24. doi:10.1210/er.2004-0005. PMID 15615818.
  8. ↑ Thieblemont C, Mayer A, Dumontet C, Barbier Y, Callet-Bauchu E, Felman P; et al. (2002). "Primary thyroid lymphoma is a heterogeneous disease". J Clin Endocrinol Metab. 87 (1): 105–11. doi:10.1210/jcem.87.1.8156. PMID 11788631.
  9. ↑ Nielsen J, Pedersen FM, Knudsen F, Jensen MB, Ibsen M (1993). "Accuracy of 94 anaesthetic agent vaporizers in clinical use". Br J Anaesth. 71 (3): 453–7. PMID 8398533.
  10. ↑ 10.0 10.1 10.2 Siderys H, Rowe GA (1970). "Superior vena caval syndrome caused by intrathoracic goiter". Am Surg. 36 (7): 446–50. PMID 4913941.

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